The Allergy Mom® Melissa Scheichl Provides Education and Support

Melissa Scheichl

Growing up Melissa Scheichl (aka The Allergy Mom®) of the Greater Toronto Area of Ontario, Canada, had both seasonal and food allergies and her mother suffered a dangerous anaphylactic reaction to a bee sting. As challenging and scary as these experiences were, however, allergies did not become a major focus of her life until her children were born almost 16 and 14 years ago.  
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US Senators Introduce Airline Emergency Epi Bill

Just as you would expect an airline to carry a defibrillator for a heart attack emergency, the Food Allergy Research & Education (FARE) group believes airlines should also be prepared to treat serious allergic reactions. Fortunately there is a group of U.S. senators who agree, and are sponsoring legislation that would require airlines to stock epi-pens for use on anyone in an emergency.

Image of an airplane wing

FARE Champions Bipartisan Federal Legislation to Improve Air Travel for Individuals and Families Managing Food Allergies

Coalition of Patient Groups Supports New Legislation Calling for Comprehensive Study of Airline Policies, Access to Emergency Medicine in Flight and Crewmember Training

August 6th, 2015

McLEAN, VA (Aug. 6, 2015) — Sen. Mark Kirk (R-IL) and Sen. Jeanne Shaheen (D-NH) on Wednesday introduced the Airline Access to Emergency Epinephrine Act (S. 1972), bipartisan legislation championed by Food Allergy Research & Education (FARE), the leading advocacy organization working on behalf of the 15 million Americans with food allergies, and a coalition of patient advocacy groups. This bill directs the U.S. Government Accountability Office (GAO) to generate a national report examining airline policies for accommodating passengers with food allergies, and would require airlines to carry epinephrine auto-injectors for use in allergic emergencies.

The Airline Access to Emergency Epinephrine Act, which is also cosponsored by Sens. Ben Cardin (D-MD) and Mark Warner (D-VA), directs the GAO to conduct and submit a report to Congress on air carrier policies relating to passengers with food allergies. This report will cover a range of topics important to the food allergy community, including the content and variability of existing accommodation policies, as well as how those policies are applied, how staff are trained to carry them out and how passengers learn about and utilize them. The study will also explore the incidence of in-flight reactions and emergency landings, costs of emergency landings, and the resources required to develop model accommodation policies.

The bill also directs the Federal Aviation Administration and individual airlines to clarify that the 1:1,000 epinephrine ampules that are currently included in emergency medical kits are intended to be used for the treatment of anaphylaxis. Finally, the Airline Access to Emergency Epinephrine Act will direct airlines to carry epinephrine auto-injectors and calls for crewmembers to be trained how to recognize the symptoms of an acute allergic reaction and how to administer auto-injectable epinephrine.

"Air travel can be particularly stressful for individuals and families managing food allergies because they do not have access to emergency medical care," said Scott Riccio, senior vice president of education and advocacy at FARE. "This legislation will help address some of the biggest challenges faced by airline passengers with food allergies. Our hope is that the findings of the GAO report will lead to the development of clear, consistently applied accommodation policies to help passengers with food allergies make informed choices about their air travel plans. This bill also recognizes the value of carrying easy-to-use epinephrine auto-injectors on aircraft in a manner similar to automatic defibrillators, and includes important provisions that would provide better instructions for use of epinephrine in allergic emergencies."

Sen. Kirk and Sen. Shaheen have both been longtime supporters of families managing food allergies. Sen. Kirk was the lead Republican sponsor of the School Access to Emergency Epinephrine Act, which President Obama signed into law in November of 2013, and Sen. Shaheen was one of the bill's original co-sponsors.

"Travelers with severe allergies deserve peace of mind that their flight crew can respond to an allergy attack," Sen. Kirk said. "Ensuring epinephrine is available on every flight will make flying safer and could save lives."

"Every day, more than one million passengers in the United States trust their safety and well-being to airlines," Sen. Shaheen said. "It's important that those airlines are properly equipped to handle emergencies, which should include having epinephrine on board, along with trained personnel to administer it."

Working with Sen. Kirk and Sen. Shaheen to introduce this important legislation is one of a number of actions FARE and fellow advocacy organizations are taking to improve air travel for the food allergy community.

In 2014, FARE convened a coalition group of patient advocacy organizations to present a unified voice regarding the steps that the airline industry can take to better accommodate passengers with food allergies. In addition to FARE, the group includes Allergy & Asthma Network, the Asthma and Allergy Foundation of America and No Nut Traveler. FARE has worked with coalition partners to develop a set of key priorities, all of which are addressed in the federal legislation introduced today.

In addition to FARE and the coalition partners, the American Academy of Allergy, Asthma & Immunology and the Association of Flight Attendants have endorsed the Airline Access to Emergency Epinephrine Act.

We need your help! Please visit the FARE Action Center, join the Advocates Network and click on the Action Alert to send your senators a message urging them to co-sponsor this important legislation! Or, thank the senators who've already signed on!

Parental Guidance for School 504s and IHCPs

Here are some very practical guides for developing Emergency Care Plans, Individualized Healthcare Plans and 504 Plans for children with allergies in school. Links to sample plans and descriptions of each type are included. If you can start the process now, everything will be in place by the first day of school.

Cartoon of a kid with books going to school

Back to School Suggestions for Families with Life-threatening Allergies

August 10th, 2015
By Janet Goldman

If you have a child with severe allergies, it may be a good idea to arrange a meeting with your school’s principal, preferably before the school year begins. Begin by explaining your child’s allergies, and then request a health care plan to provide for his/her safety at school. This plan should identify responsibilities, training and services to guarantee a safe environment as well as how to respond to an attack of anaphylaxis.

There are three plans commonly used for children with food allergies: Emergency Care Plans, Individualized Healthcare Plans and 504 Plans. The Emergency Care Plan includes what your child is allergic to, his/her symptoms, the recommended treatment, instructions for calling 911 to take your child to the hospital and emergency contacts. The Individualized Healthcare Plan includes the Emergency Care Plan and explains what the school team will do to decrease the likelihood of allergen exposure, recognition of symptoms and quick treatment. The 504 Plan is similar to the Individualized Healthcare Plan but is also legally binding with a procedure for complaints.

Section 504 is part of a federal civil rights law, the Rehabilitation Act of 1973. This is a written management plan which explains how your child’s school will meet his/her individual needs throughout the school day, ensuring his/her safety. This plan can include multiple components concerning school staff, how they will be trained, use and training of substitute teachers, emergency procedures, the cafeteria and bus transportation. An important part of this plan is a section which explains how to recognize and treat an allergic reaction. Here is a link to a Webinar describing differences between 504 and IHCPs.

http://community.kidswithfoodallergies.org/blog/food-allergy-school-health-plans-504-vs-ihcp-video-and-resources

Sample 504 Plans can be found at:

http://www.kidswithfoodallergies.org/page/sample-section-504-plan-for-food-allergy.aspx

Approval for a 504 Plan may require documentation from your child’s allergist indicating the assessment that your child’s allergies could cause life-threatening reactions. If your allergist thinks your child should have access to an epinephrine auto injector at certain locations, you could request an accommodation from your school. Your child might not qualify for such a plan. Instead, you could request an Individualized Health Care Plan. After developing your child’s plan, whichever it may be, make sure that it’s in writing. Review it yearly and adjust as necessary to meet your child’s changing needs. A sample Individualized Health Care Plan can be found at:

https://www.health.ny.gov/professionals/protocols_and_guidelines/docs/caring_for_students_with_life_threatening_allergies.pdf

If your school won’t make accommodations for your child’s health care needs, contact your district’s superintendent or your district’s 504 Coordinator, in writing. If necessary your next step might be to contact the New York Department of Education which enforces compliance.

In private schools which are not funded by federal money, students with severe allergies can be protected by the Americans with Disabilities Act. Similar health care plans can be established in these schools. Colleges which receive some form of federal funding assistance are also covered by Section 504 regulations. (See “Going to College Preparation Strategies, by the Allergy & Asthma Network.)

As summer ends and fall begins, good luck and best wishes from the Allergy Advocacy Association!

Emergency visits for childhood food allergy rise in Illinois

It comes as no surprise that emergency room visits of children with severe allergic reactions have increased markedly over the past five years in Illinois. Researchers are still trying to find out why, and are pursuing ways to reverse the trend.

Northwestern  University logo

Visits for anaphylaxis climb 29 percent per year; while Hispanic children's visits are up 44 percent per year.

NORTHWESTERN NEWS
June 28th, 2015

CHICAGO – Emergency room visits and hospitalizations of children with severe, potentially life-threatening food allergy reactions increased an average of nearly 30 percent per year over five years in Illinois, reports a Northwestern Medicine study.

Hispanic children, who previously had the lowest reported cases of food allergies, had the biggest increase of emergency room and hospitalizations overall with a 44 percent average annual rise.

The children in the study experienced anaphylaxis, which can include difficulty breathing, reduced blood pressure, loss of consciousness and potentially death.

"This study shows that severe food allergies are beginning to impact children of all races and income," said lead study author Dr. Ruchi Gupta, a professor of pediatrics at Northwestern University Feinberg School of Medicine and an attending physician at Ann & Robert H. Lurie Children's Hospital of Chicago. "This is no longer primarily a disease of children who are white and/or from middle-to-high income families. Nobody is immune to it."

The study included discharge data from 1,893 emergency room visits at about 200 Illinois hospitals from 2008 to 2012. It will be published June 26 in Annals of Allergy, Asthma & Immunology.

Previously, studies have shown the most affected children with food allergies were white or from higher-income families. Hispanic children and children from lower socioeconomic families were least affected, Gupta said. Scientists don't know why some ethnicities/races and socioeconomic levels have been more susceptible to food allergies than others.

The study showed an average annual increase of 29.1 percent from 6.3 emergency department visits and hospital admissions per 100,000 children in 2008 to 17.2 emergency department visits and hospital admissions in 2012. Visits were most frequent each year for Asian children. However, the annual percent increase in visits was most pronounced among Hispanic children at 44.3 percent.

Visits by African American children rose an average of 28.1 percent annually with white children up 30.6 percent. The most common allergies causing emergency treatment for all populations were tree nuts, peanuts and milk.

"Ensuring timely diagnosis by the physician and education about recognition and management of severe and potentially fatal reactions is critical," Gupta said. "We need targeted education to all families and public entities including schools, camps and restaurants because anaphylaxis can happen anywhere and at any time."

Food allergy is a growing public health concern in the United States that affects an estimated 8 percent of children, according a 2011 study by Gupta. Nearly 40 percent of children with food allergy have a history of severe reactions that can lead to hospitalization or even death without immediate treatment.

Scientists are still trying to understand why food allergies are rising among children. One theory is children in industrialized countries live in overly clean environments and are not exposed to enough bacteria, Gupta said.

In addition, research has shown introducing common allergens early, such as peanuts, may reduce the chances of a child developing food allergies. It also has been theorized the diversity of gut flora, which is largely influenced by diet, determines whether or not a person will develop food allergies.

Gupta also is a researcher at the Center for Community Health at the Institute for Public Health and Medicine at Feinberg.

Other Northwestern and Lurie Children's Hospital authors on the paper are lead author Ashley A. Dyer and Claudia H. Lau, Tracie L. Smith and Bridget Smith.

The study was supported by Food Allergy Research & Education.

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